The role of patient-centered communication and shared decision-making in treatment knowledge and decision preparedness among people with urologic cancers: Findings from the Cancer Experience Registry.

359 Background: Healthcare providers’ ability to successfully engage in patient-centered communication (PCC) and shared decision making (SDM) is critical for prioritizing patient values and needs given the diversity of cancer treatment options available. This study aims to examine the impact of PCC and SDM on urologic cancer patients’ perceived knowledge and preparedness in treatment decision-making. Methods: Participants in Cancer Support Community’s Cancer Experience Registry reported sociodemographic and clinical information, decision-making style (provider-led, patient-led, shared), knowledge about cancer treatment options and financial impact as well as preparedness to make treatment decisions (on 5-pt scale, dichotomized for analysis), and PCC (6-item PCC short form). We ran three logistic regression models adjusting for sociodemographic and clinical factors, with outcomes: (1) knowledge of treatment options, (2) knowledge of financial impact, (3) and preparedness for treatment decisions. Results are reported as odds ratios (ORs) with 95% confidence intervals (CIs). Results: The sample included 254 U.S. adults (75% men; ages 24-90 [Mean = 68, SD = 11]) with urologic cancer (54% prostate, 29% bladder, 15% kidney, 2% testicular), 48% in remission, 24% localized, 20% metastatic; 3yr Median time since diagnosis; 85% non-Hispanic White, 58% held a Bachelor’s degree or higher, and 58% had income ≥$40K. Decision-making styles were 58% patient-led, 31% shared, and 12% HCP-led. 54% felt quite a bit or very much knowledgeable about treatment options, 34% about financial impacts, and 56% prepared for treatment decisions. PCC scores were negatively skewed, indicating strong communication; a median split (Mdn = 4) was used in regressions. Higher PCC significantly predicted greater knowledge of treatment options (OR = 1.74[1.02-2.95]) and financial impact (OR = 2.02[1.10-3.70]) as well as feeling prepared to make treatment decisions (OR = 2.86[1.62-5.03]), adjusting for controls. Further, SDM (OR = 5.63[1.98-16.06]) and patient-led decision-making (OR = 5.53[1.85-16.55]) predicted greater preparedness than HCP-led decisions. Conclusions: Among urologic cancer patients, more than half reported good treatment knowledge and treatment preparedness, while only a third felt well informed of financial impacts of treatment. PCC was high and predicted greater perceived knowledge about treatment and finances, even when accounting for key sociodemographic and clinical factors. Additionally, both PCC and SDM predicted feeling prepared to make treatment decisions. Findings suggest that PCC and SDM play a critical role in patient experiences and strengthening these approaches in clinical settings may help ensure that care is more aligned with patients’ values, preferences, and needs.